Individual
SHELLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 HUGH WALLIS RD S STE B2, LAFAYETTE, LA 70508-2528
(337) 205-4444
Mailing address
515 S COLLEGE RD, LAFAYETTE, LA 70503-3352
(337) 269-1165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
05/02/2022
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